Demetris Allen Green Md | |
10610 Fondren Rd Ste 124 Houston TX 77096-5422 | |
(713) 981-5167 | |
(713) 981-5553 |
Full Name | Demetris Allen Green Md |
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Speciality | General Practice |
Location | 10610 Fondren Rd, Houston, Texas |
Authorized Official Name and Position | Demetris Allen Green (PHYSICIAN) |
Authorized Official Contact | 7133839003 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Demetris Allen Green Md 8299 Cambridge St Apt 1203 Houston TX 77054-3141 Ph: (713) 383-9003 | Demetris Allen Green Md 10610 Fondren Rd Ste 124 Houston TX 77096-5422 Ph: (713) 981-5167 |
NPI Number | 1669609459 |
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Provider Enumeration Date | 06/18/2009 |
Last Update Date | 06/22/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669609459 | NPI | - | NPPES |
613884700 | Other | TX | US DEPARTMENT OF LABOR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | J4168 (Texas) | Primary |
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